Bone pain is usually deep, penetrating, or dull. It commonly results from injury. Other less common causes of bone pain include bone infection (osteomyelitis), endocrine disorders, and tumors.
Muscle pain (known as myalgia) is often less intense than bone pain but can be very unpleasant. For example, a muscle spasm or cramp (a sustained painful muscle contraction) in the calf is an intense pain that is commonly called a charley horse. Pain can occur when a muscle is affected by an injury, loss of blood flow to the muscle, infection, or a tumor.
Tendon and ligament pain is often less intense than bone pain. It is often described as "sharp" and is worse when the affected tendon or ligament is stretched or moved and is usually relieved by rest. Common causes of tendon pain include tendinitis, tenosynovitis, lateral or medial epicondylitis, and tendon injuries. The most common cause of ligament pain is injury (sprains). Bursae, small fluid-filled sacs, provide a protective cushion around joints. Pain in a bursa can be caused by trauma, overuse, gout, or infection. Usually, pain is worse with movement involving the bursa and is relieved by rest. The affected bursa may swell. Bursitis is the common name for this condition.
Joint pain (called arthralgia) may or may not be related to joint inflammation (called arthritis). Arthritis may cause swelling as well as pain. A wide variety of disorders can cause arthritis, including inflammatory arthritis (such as rheumatoid arthritis), osteoarthritis, infectious arthritis, gout and related disorders, autoimmune and vasculitic disorders (such as systemic lupus erythematosus), osteonecrosis, and injuries affecting the part of a bone inside a joint. Arthritic pain can be new (acute, for example, when caused by infections, injuries, or gout), or longstanding (chronic, for example, when caused by rheumatoid arthritis or osteoarthritis). Pain resulting from arthritis is typically worse when the joint is moved but usually is present even when the joint is not being moved. Sometimes pain originating in structures near the joint, such as ligaments, tendons, and bursae, seems to be coming from the joint.
Fibromyalgia (see Fibromyalgia) may cause pain in the muscles, tendons, or ligaments. The pain is usually experienced or causes tenderness in multiple locations and may be difficult to describe precisely but is usually not coming from the joints. Affected people usually have other symptoms, such as fatigue and poor sleep.
Some musculoskeletal disorders cause pain by compressing nerves. These conditions include the tunnel syndromes (for example, carpal tunnel syndrome—see see Carpal Tunnel Syndrome, cubital tunnel syndrome—see see Cubital Tunnel Syndrome, and tarsal tunnel syndrome—see see Tarsal Tunnel Syndrome). The pain tends to radiate along the path supplied by the nerve and may be burning. It is usually accompanied by tingling, numbness, or both.
Sometimes, pain that seems to be musculoskeletal is actually caused by a disorder in another organ system. For instance, shoulder pain may be caused by a disorder affecting the lungs, spleen, or gallbladder. Back pain may be caused by a kidney stone, abdominal aortic aneurysm, inflammation of the pancreas, or, in women, pelvic disorders. Arm pain may be caused by a heart attack (myocardial infarction).
In trying to establish the cause of joint pain, doctors first determine;
How many and which joints are involved
Whether the central part of the skeleton (such as the spine and pelvis) is involved
Whether the joint pain is acute or chronic
What factors relieve or worsen the pain
Whether there are other symptoms affecting other organs (for example, rash, fever, or dry eyes)
Determining these factors gives important clues to what disorder is likely causing the pain. Doctors do a physical examination to help determine these factors and detect other important findings that could help determine the cause of the pain.
Sometimes, the type of pain suggests where the pain has originated. For example, pain that worsens with movement suggests a musculoskeletal disorder. Pain with muscle spasm suggests that pain is caused by a muscle disorder (sometimes a chronic spinal cord injury). The site of swelling or the location of tenderness when the doctor feels (palpates) the area (for example, a joint, ligament, or bursa) or passively moves a joint often indicates the source of pain. However, often these characteristics of pain do not indicate its origin or cause. Thus, doctors usually base a specific diagnosis on the presence of other symptoms, physical examination findings, and often the results of laboratory tests and x-rays/MRI.
For example, Lyme disease often causes joint pain with swelling and a bull's eye-like rash, and blood tests show antibodies to the bacteria that cause Lyme disease. Gout is characterized by a sudden attack of pain, swelling, and redness in the joint at the base of the big toe or other joints; tests of the joint fluid generally show the presence ofuric acid crystals.
Musculoskeletal Pain is pain that affects the muscles, ligaments and tendons, and bones.
What Causes Musculoskeletal Pain?
The causes of musculoskeletal pain are varied. Muscle tissue can be damaged with the wear and tear of daily activities.
Trauma to an area (jerking movements, auto accidents, falls, fractures, sprains, dislocations, and direct blows to the muscle) also can cause musculoskeletal pain.
Other causes of pain include postural strain, repetitive movements, overuse, and prolonged immobilization. Changes in posture or poor body mechanics may bring about spinal alignment problems and muscle shortening, therefore causing other muscles to be misused and become painful.
What Are the Symptoms of Musculoskeletal Pain?
People with musculoskeletal pain sometimes complain that their entire bodies ache. Their muscles may feel like they have been pulled or overworked. Sometimes, the muscles twitch or burn. Symptoms vary from person to person, but the common symptoms are:
Pain is the most common symptom of most musculoskeletal disorders. Pain ranges from mild to severe and from acute and short-lived to chronic and of long duration and may be local or widespread (diffuse).
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